Attention to spirituality is mandated internationally in end-of-life and hospice care (World Health Organization, 2002); nevertheless researchers in this area must regularly ask both carers and the recipients of care what this means (McGrath, 1999). A growing consensus suggests spiritual needs should be considered in healthcare (Speck, Higginson, & Addington-Hall, 2004), particularly with serious or terminal illness, but the same literature varies widely about definitions of spirituality.
The research from New Zealand (NZ) reported here is a contribution to this dialogue, and part of a wider project that investigated spirituality in NZ end-of-life care. According to the NZ Palliative Care Strategy, ‘Palliative care services: integrates physical (tinana), social (whānau), emotional (hinengaro) and spiritual (wairua) aspects of care to help the dying person and their family/whānau attain an acceptable quality of life’ (Ministry of Health, 2001, p. 10).
This biopsychosocialspiritual model (Sulmasy, 2002) is holistic and makes interconnections and integration between the dimensions with elements in common in other models. For example, Te Whare Tapa Wha (Durie, 1998) is a holistic Māori (NZ indigenous peoples) model widely used in NZ healthcare and education contexts. It is based on the structure of the whare or meeting house and each of the four walls represent a dimension of hauora or well-being: physical, mental, social and spiritual. Te taha wairua or the spiritual dimension ‘is generally acknowledged to be the most basic and essential requirement for health’ (Durie, 1985, p. 483).
Pacific Island models are similarly holistic, such as the Samoan ‘fono fale’ (Capstick, Norris, Sopoaga, & Tobata, 2009), with each of these paralleling the hospice’s ‘total care’ model (Saunders, 2004).
Recent or current spirituality in healthcare projects
- Spiritual care in healthcare: an HRC activation grant aiming to understand and reform spiritual care across Aotearoa New Zealand’s healthcare system
- Spiritual views and needs of Aotearoa New Zealand communities: an investigation of what community members think about spirituality, spiritual needs and care